Trauma center levels: Difference between revisions
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*May provide surgery and critical-care services if available | *May provide surgery and critical-care services if available | ||
*Transfer agreements with Level I and/or Level II Trauma Centers | *Transfer agreements with Level I and/or Level II Trauma Centers | ||
==Criteria for Transport to Trauma Center<ref>Gross EA, Martel ML. Multiple trauma, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 36: 287-295.</ref>== | |||
*Abnormal vital signs | |||
**BP < 90 | |||
**RR < 10 or > 30 | |||
**GCS < 14 | |||
*Penetrating trauma to head, neck, torso, proximal extremities | |||
*Flail chest | |||
*Two or more long bone fxs | |||
*Mangled extremities | |||
*Pelvic fx | |||
*Depressed skull fx | |||
*Neuro deficit | |||
*Vehicle ejection | |||
*Death in same passenger compartment | |||
*Significant vehicle extrusion | |||
*Pedestrian or bicyclist struck by vehicle with significant impact | |||
*Motorcycle crash > 20 mph | |||
*Elderly or children | |||
*Pts on anticoagulants | |||
*Pregnant pts > 20 wks gestation | |||
==Sources== | ==Sources== | ||
Revision as of 19:32, 12 January 2016
Back Ground
- Trauma centers are categorized from Level I-V with designation of adult and pediatric care
- Centers are evaluated and verified by the ACS
US Trauma Center Levels
Level I
- 24-hour in-house coverage by gen surg, and prompt availability of care in ortho, NS, anesthesiology, EM, IM, rads, plastics, OMFS, and critical care
- Referral center
- Community leadership and education
- Continuing education
- QA program
- Operates an organized teaching and research effort
Level II
- 24-hour immediate coverage by gen surg, as well as coverage by ortho, NS, anesthesiology, EM, rads, and critical care
- Tertiary care needs such as CT surg, need for HD, vasc surg may be referred to a Level I Trauma Center
- Provides trauma prevention and to continuing education programs
- QA program
Level III
- 24-hour immediate coverage by EM providers and the prompt availability of gen surg and anesthesiology
- QA program
- Transfer agreements with Level I and/or Level II Trauma Centers
- Provides back-up care for rural and community hospitals
- Continuing education
Level IV
- Basic ED which can implement ATLS protocols ("trauma nurse" and physician)
- 24-hour labs
- May provide surgery and critical-care services
- Transfer agreements with Level I and/or Level II Trauma Centers
- QA program
Level V
- Basic ED which can implement ATLS protocols ("trauma nurse" and physician)
- After-hours activation protocols if facility is not open 24-hours a day
- May provide surgery and critical-care services if available
- Transfer agreements with Level I and/or Level II Trauma Centers
Criteria for Transport to Trauma Center[1]
- Abnormal vital signs
- BP < 90
- RR < 10 or > 30
- GCS < 14
- Penetrating trauma to head, neck, torso, proximal extremities
- Flail chest
- Two or more long bone fxs
- Mangled extremities
- Pelvic fx
- Depressed skull fx
- Neuro deficit
- Vehicle ejection
- Death in same passenger compartment
- Significant vehicle extrusion
- Pedestrian or bicyclist struck by vehicle with significant impact
- Motorcycle crash > 20 mph
- Elderly or children
- Pts on anticoagulants
- Pregnant pts > 20 wks gestation
Sources
American Trauma Society - http://www.amtrauma.org/?page=TraumaLevels
- ↑ Gross EA, Martel ML. Multiple trauma, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 36: 287-295.